70岁以上冠状动脉旁路移植术病人乳内动脉流量测量分析

目的 分析70岁以上冠状动脉旁路移植术病人乳内动脉旁路血管血流量的特点.方法 对2003年1月至2007年1月间78例70岁以上(含70岁)应用乳内动脉非体外循环冠状动脉旁路移植手术(OPCAB)的病人,使用瞬时超声血流测量技术对其乳内动脉平均血流量、搏动指数等指标进行测量并分析.结果 78例病人83根乳内动脉旁路血管平均流量(36.0±21.5)ml/min,平均搏动指数3.50±1.76,血流波形均以舒张期为主.男女性别比、平均流量和搏动指数差异无统计学意义(39.0±23.1) ml/min对(28.0±14.7) ml/min;(3.30±1.50)对(4.10±2.22),P>0.05],但女病人平均流量较男病人偏低,搏动指数较男病人偏高.结论 70岁以上病人冠状动脉旁路移植术应用乳内动脉是安全、有效的;对老年病人乳内动脉流量的评价分析应当结合老年病人的病变特点.

The measurement of internal mammary artery flow for elderly patients over 70 years in coronary artery bypass graft

Objective To analyze the characteristic of internal mammary artery (IMA) flow for elderly patients over 70 years in coronary artery bypass graft (CABG). Methods From January 2003 to January 2007, 78 patients over 70 years old underwent CABG using internal mammary artery grafts. The mean value of flow (Qm), pulsatility index (PI) and the flow wave of IMA were measured with transit-time flow meter (TTFM) and analyzed. Results 78 patients used 83 IMA grafts (5 patients used bilateral IMA). The mean value of Qm was (36.0 ± 21.5) ml/min, and mean PI was 3.50 ± 1.76, the main wave of flow was in diastolic period. In these patients, there was no statistic significant difference between male and female patients Qm (39.0 ± 23.1 ) ml/min vs. ( 28.0±14.7 ) ml/min, PI 3.30 ± 1.50 vs. 4.10 ± 2.22, P ＞ 0.05 ], but the Qm of male patients group was higher than that of female patient group and PI was lower in male. Conclusion Using of IMA in CABG is safe and effective in elderly patients over 70 years. When evaluating IMA in elderly patients after CABG, the pathological changes should be considered.